The new air-QTM intubating laryngeal airway for tracheal intubation in children with anticipated difficult airway: a case series

The air-Q intubating laryngeal airway (ILA) is a new supraglottic airway device which may overcome some limitations inherent to the classic laryngeal mask airway for tracheal intubation. We present a case series of patients with anticipated difficult airway in whom the air-Q ILA was successfully used as a conduit for fiberoptic intubation.     

Generative artificial intelligence: Can ChatGPT write a quality abstract?

ChatGPT is a generative artificial intelligence chatbot which may have a role in medicine and science. We investigated if the freely available version of ChatGPT can produce a quality conference abstract using a fictitious but accurately calculated data table as applied by a non-medically trained person. The resulting abstract was well written without obvious errors and followed the abstract instructions. One of the references was fictitious, known as ‘hallucination’. ChatGPT or similar programmes, with careful review of the product by authors, may become a valuable scientific writing tool. The scientific and medical use of generative artificial intelligence, however, raises many questions.     

Pseudoaneurysm of the mitral-aortic intervalvular fibrosa following endocarditis and aortic valve surgery in an infant—Case report and exhaustive systematic review of pediatric cases

Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (P-MAIVF) continues to be a rare diagnosis in children. Etiology, presentation, and management strategies are considerably different from adults. We report a fatal case of P-MAIVF with classical transthoracic and transesophageal echocardiographic findings complemented by CT imaging. The natural course of uncomplicated/asymptomatic P-MAIVF is largely unknown since most patients are offered surgery. We present an extensive literature review of pediatric P-MAIVF and highlight important differences from the adult form of this disease.     

Diagnosing pediatric appendicitis

Appendicitis is the most common surgical cause of abdominal pain in children, The diagnosis is fairly straightforward in a child with the classic history of epigastric or periumbilical pain followed by anorexia, nausea, or vomiting, with migration of pain to the right lower quadrant of the abdomen and low-grade fever. It is the child with an equivocal history or physical examination that provides the diagnostic challenge. The additions of ultrasonography and computed tomography to the radiologic evaluation has improved the clinician's ability to diagnose appendicitis, but the diagnosis is not always made.     

Grafting of the peritonsillar fossa with an acellular dermal graft to reduce posttonsillectomy pain

PURPOSE: Adult tonsillectomy is a common surgical procedure that is accompanied by masked postoperative pain. Analgesics are usually only partially effective, and the use of narcotics such as codeine is often poorly tolerated because of associated nausea. Because the pain associated with tonsillectomy is believed to arise from the large areas of exposed parapharyngeal muscle, we hypothesized that acellular dermal grafting of the peritonsillar fossa, providing biologic coverage to these areas, would result in a notable reduction of postoperative pain. MATERIALS AND METHODS: We did a double-blind, prospective study, with 10 adult patients undergoing electrodissection tonsillectomy concurrently with grafting of 1 peritonsillar fossa with an acellular dermal graft (ADG) (AlloDerm, LifeCell Corp, The Woodlands, TX), whereas the other side of the throat received no treatment and was designated as the control side. Patients were examined on postoperative days 1, 7, and 14, and completed pain questionnaires on postoperative days 1, 3, 5, 7, and 14. RESULTS: ADG grafting of the peritonsillar fossa resulted in a statistically significant reduction in pain (by approximately 50%) on postoperative days 1, 3, 5, and 7, compared with the control side. Two patients experienced partial graft sloughing within the first 10 postoperative days, but no other untoward effects such as bleeding, graft aspiration, or infection, were associated with ADG of the peritonsillar fossa. CONCLUSIONS: This study suggests that AlloDerm grafting of the peritonsillar fossa is a potentially useful, alternative means of reducing pain in the adult tonsillectomy patient and has potential use in reconstruction of oropharyngeal defects. Because of the cost of the graft, we suggest its use in selected difficult adult cases, but not as part of routine adult tonsillectomy.